Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
BCBSRI Update
P B F
1 Mar, 2025
Upon enrollment, our members are granted certain rights – and protection of these rights – in all th...
P
1 Mar, 2025
We would like to make you aware of the rise in Durable Medical Equipment (DME) fraud and the various...
F
1 Mar, 2025
At BCBSRI, we continue to improve our members’ health and peace of mind by facilitating their access...
Provider Relations
P B F
1 Mar, 2025
BCBSRI invites providers to join us on Tuesday, 11 de março, 2025 from 10-11 a.m. for a conference...
P B F
1 Mar, 2025
the annual D-SNP training by 31 de março, 2025. To help providers complete the training, we are offerin...
P
1 Fev, 2025
BCBSRI has temporarily waived the referral requirement for all plans for claims with a date of servi...
Physician & Provider Call Center
P B F
1 Jul, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
1 Jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check me...
Quality
P
1 Mar, 2025
The Centers for Medicare and Medicaid Services (CMS) has introduced two new Part D Star Measures for...
P
1 Fev, 2025
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) is an industry standard survey ...
P
1 Jan, 2025
It’s almost that time of year again, HEDIS® medical record review time! Every year BCBSRI takes part...
Behavioral Health
P B
1 Mar, 2025
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
B
1 Mar, 2025
Non-suicidal self-injury (NSSI) is a behavior in which an individual inflicts physical harm on onese...
P B
1 Mar, 2025
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
Farmácia
P B F
1 Mar, 2025
Large Group and Small Group Markets FormularyThe information below is effective as of 1 de abril, 2025,...
P F
1 Fev, 2025
The following drugs will require authorization in 2025:Drug NameGenericCodeMedicare Effective DateCo...
P F
1 Dez, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
Products & Benefits
P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Reivindicações
P B F
1 Abr, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
1 Jan, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
1 Nov, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
F
1 Mar, 2025
2025 Coding and Payment Guidelines Modifiers Modifier 27 has been added to this policy. Modifie...
P F
1 Mar, 2025
Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial VaginosisEffective 1 de maio, 2...
P F
1 Mar, 2025
The following policies were recently reviewed for annual update. The full texts of these policies ar...